To read more about this topic, read "Metastatic Colorectal Cancer."
▶Patients with limited metastatic disease to the liver or lungs may be eligible for complete resection upfront or after neoadjuvant therapy, and many will have long PFS or even cure
▶Metastatic colon cancer can affect up to 50% of patients diagnosed with the disease
▶Appropriate evaluation of the extent of the disease and patients' general health by a multidisciplinary team will determine goals of treatment
▶Patients with widely metastatic disease will benefit from different systemic chemotherapy regimens given sequentially and punctuated by "chemo holidays." With this strategy, survival can be doubled or tripled
▶Managing toxicity from systemic chemotherapy is paramount to maintain QOL. Myelosuppression, mucositis, cold-induced neuropathy, fatigue, and rash are the most common AEs and can be managed to maintain QOL
▶Hypertensive crisis, bleeding or thrombosis, GI perforation, and RPLS should prompt the discontinuation of bevacizumab and similar drugs
▶Biologic agents, such as antiangiogenic and anti-EGFR agents, when used with chemotherapy, added some benefit but their effect was not equal across treatment regimens
▶5-FU is considered the staple for all chemotherapy regimens used in this disease. The addition of irinotecan or oxaliplatin to 5-FU improved RRs and PFS but did not always result in improvement of OS.
